Mobile phone access and comfort: implications for HIV and tuberculosis care in India and South Africa.

Post Date: 
Clinical Sites: 
International Journal of Tuberculosis and Lung Disease

SETTING: India and South Africa shoulder the greatest burden of tuberculosis (TB) and human immunodeficiency virus (HIV) infection respectively, but care retention is suboptimal.

OBJECTIVE: We conducted a study in Pune, India, and Matlosana, South Africa

  1. to identify the factors associated with mobile phone access and comfort of use,

  2. to assess access patterns.

DESIGN: A cross-sectional study assessed mobile phone access, and comfort; a longitudinal study assessed access patterns.

RESULTS: We enrolled 261 participants: 136 in India and 125 in South Africa. Between 1 week and 6 months, participant contact decreased from 90% (n = 122) to 57% (n = 75) in India and from 93% (n = 116) to 70% (n = 88) in South Africa. In the latter, a reason for a clinic visit for HIV management was associated with 63% lower odds of contact than other priorities (e.g., diabetes mellitus, maternal health, TB). In India, 57% (n = 78) reported discomfort with texting; discomfort was higher in the unemployed (adjusted OR [aOR] 4.97, 95%CI 1.12-22.09) and those aged ≥35 years (aOR 1.10, 95%CI 1.04-1.16) participants, but lower in those with higher education (aOR 0.04, 95% CI 0.01-1.14). In South Africa, 91% (n = 114) reported comfort with texting.

CONCLUSION: Mobile phone contact was poor at 6 months. While mHealth could transform TB-HIV care, alternative approaches may be needed for certain subpopulations.

Cox SN, Elf JL, Lokhande R, Ogale YP, DiAndreth L, Dupuis E, Milovanovic M, Mpongose N, Mave V, Suryavanshi N, Gupta A, Martinson N, Golub JE, Mathad JS. Mobile phone access and comfort: implications for HIV and tuberculosis care in India and South Africa. Int J Tuberc Lung Dis. 2019 Aug; 23(7):865–872.
  • Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  • Byramjee Jeejeebhoy Medical College (BJMC), Pune, India.
  • Johns Hopkins School of Nursing, Baltimore, MD, USA.
  • Perinatal HIV Research Unit, South Africa Medical Research Council Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Soweto, South Africa.
  • Department of Medicine, Weill Cornell Medicine, Center for Global Health, New York, NY, USA.